Goodenough-Harris Drawing a Man Test (GHDAMT) as a Substitute of Ages and Stages Questionnaires (ASQ2) for Evaluation of Cognition

Objective The main aim of the current research was evaluation of concurrent validity of the Goodenough–Harris Draw-A-Man Test (GHDAMT) with the problem-solving subscale of ASQ2 among children between 54-60 months old in Tabriz City, northwestern Iran. Materials & Methods In this cross-sectional study, 136 males and 105 females were selected by simple random sampling from nursery schools in Tabriz City, northwestern Iran in 2014 and tested with GHDAMT and ASQ2 to compare the concurrent validity of these tests in evaluation of cognition. Data were analyzed using Pearson or Spearman correlation coefficients and SPSS.16. Results The mean Intelligence Quotient (IQ) in girls was 128±18.18 and in boys 118±18.50, and the difference was statistically significant P<0.001. There was no statistically significant correlation between GHDAMT and ASQ2 .The statistical correlation was significant between IQ and mental age among children who had -2SD score in problem-solving subscale, but there was no statistical correlation between children who had -1SD score P<0.002. There was no statistically significant correlation between problem-solving subscale of ASQ2 and mental age and IQ. Conclusion GHDAMT did not have acceptable validity and concurrent validity of the test was less than 0.3. So GHDAMT cannot be used as a substitute of ASQ questionnaire. However, the correlation of two tests in children with intellectual and developmental disability was significant. After doing more studies in further research, it is possible to use GHDAMT as a proper tool for cognition evaluation of these children.


Introduction
Child development is an interesting and challenging topic for many different scientific disciplines, such as Pediatrics, Psychiatry, and Psychology, In recent years, trials have been conducted to achieve accurately and evidence-based information associated with developmental markers and normal and abnormal developmental processes (1). In this regard, parents are eager to get enough information to know whether or not their child is both developing and growing naturally. This is of particular importance in families with a history of developmental disorders and risk factors during pregnancy, such as preterm delivery, etc. Among these tests, the Goodenough-Harris Draw-

A-Man Test (GHDAMT) and the Ages and Stages
Questionnaire (ASQ) are the developmental process tests used by experts to assess children's abilities (4). In the current study, GHDAMT was selected due to being easy, cost-effective and short.
Over the years, the Goodenough Draw a Man test has been revised many times with added measures for assessing intelligence, but the origin of the test has remained unchanged. In 1949, some tried to introduce it as personality test by making changes on it (7). Harris later revised the test as GHDAMT is almost equal to a 36 months old, which is the minimum age that children can be measured with the GHDAMT. A 36 months old child acquires the ability to draw a circle and sketch a man and gradually adds body parts and details (11).
In the beginning, in respect to ethical concerns, the purpose of the study was briefly explained to all the parents participating in the study and the participants were promised that their information would be kept confidential in all articles and resources extracted from this study. There The drawing test, considering the parts and graphic details, based on test instructions was scored between 0-1 (8) and mental age was estimated after summing up the tests based on Table 1, and child IQ was originally computed by taking the ratio of mental age to chronological (physical) age and multiplying by 100. Children with physical disabilities who have difficulty using pencil were excluded from the study.
The obtained data were studied using descriptive statistics methods (Frequency, percentage and mean ± SD). Pearson or Spearman correlation coefficients were used to calculating the correlation between the two tests. Then an independent t-test was used to compare the mean of the two groups, and SPSS16 (Chicago, IL, USA) was used for statistical analysis. The P-value of less than 0.05 was considered statistically significant.

Assessment of concurrent validity and computing
of the two test's correlation by using of Pearson correlation coefficient ( There was a statistically poor significant correlation  The results of the t-test (Figure 1)revealed that the average IQ scores of children who had -2SD score in solving problem subscale, and in children -1SD the difference was statistically significant (P =0.002).
There was no statistically significant correlation between ASQ2 and GHDAMT. A statistically significant correlation between IQ and mental age in the children who failed the problem-solving domain (less than -2SD) was seen P<0.002. However, the correlation was not significant in children whose ASQ2 score was higher than -2SD.
The reliability of GHDAMT was not acceptable and concurrent validity was less than 0.3.

Discussion
The aim of the current study was evaluation of the concurrent validity of two tests: the ASQ2 questionnaire and the GHDAMT. In order to compare these two tests, since GHDAMT assess the child's cognition, the problem-solving subscale in ASQ2 questionnaire was selected.

Battelle Developmental Inventory
There was almost 84% consistency between the results (3). The screening questionnaires completed by parents were as accurate as the ones done by pediatricians (15). The studies carried out on the ASQ2 in Iran verified its validity and reliability (16).
There are other researches questioning the validity of this type of questionnaires filled out by parents in public places (17